Which side really wants to gut Medicare? That question has emerged at the forefront of the presidential campaign. In the process, what's getting gutted is facts -- and, quite possibly, chances of meaningful Medicare reform.
Mitt Romney and Paul Ryan claim that President Barack Obama would "rob" Medicare with $716 billion in cuts to pay for Affordable Care Act programs. Team Obama claims the Romney-Ryan reform plans would eviscerate Medicare and saddle seniors with huge medical bills.
Nonpartisan fact-checkers such as PolitiFact.com assert that while both sides are guilty of truth-bending "Medi-scare" tactics, Republicans are the worse offenders. Conservatives counter that the fact-checkers are biased. A lie, it seems, is often in the eye of the beholder.
Take Republican charges about Obama's Medicare cuts. Obama defenders point out that the $716 billion figure refers to cost reductions that the Congressional Budget Office projects will result from Obama's health care reform law between 2013 and 2022. The law authorizes a government panel to lower costs by restructuring Medicare programs, mainly by cutting payments to doctors and hospitals.
This is not a "death panel." Its goal is to root out fraud and waste, and it is expressly prohibited from cutting benefits or denying treatment. Still, critics have a point when they argue that the squeeze on reimbursements could lead to Medicare recipients being offered fewer services. So, while claims of granny-robbing are full of melodramatic exaggeration, they have more truth than the president's champions will concede.
Likewise, there is some truth to assertions that the money saved through these cuts will be channeled to untested new government programs. Obamacare may not be the bogeyman painted by its foes, but even many supporters agree it is unlikely to reduce overall government spending on health care, especially when it subsidizes new benefits (such as full coverage of preventive checkups and birth control, even for those who can afford out-of-pocket payments).
Meanwhile, Romney promises to repeal all of Obama's health care law, including the Medicare cuts -- even though the same reductions are incorporated into Ryan's much-vaunted budget plan. Ryan's plan is not Romney's, but neither Romney nor Ryan has explained what budget changes they propose to offset the loss of those savings. Even if the Affordable Care Act is repealed, there is near-universal agreement that it will have to be replaced with other programs requiring funds.
Much Democratic criticism has focused on Ryan's Medicare reform plan (which Romney largely embraces), which would keep the existing system for anyone currently 55 or older, then phase in vouchers to help seniors buy private insurance. Democrats have claimed this could force seniors to pay as much as $6,400 a year in additional premiums. But that figure is based on an earlier version of Ryan's plan -- which, unlike the new one, did not allow future retirees the option of traditional Medicare, and had a more draconian Medicare spending cap. There are no reliable estimates of what the new Ryan plan may mean to seniors. (Whether it will make a dent in the deficit is also questionable; Medicare Advantage, which allows competition from private insurers, lowers premium costs for beneficiaries but boosts government spending.)
Health care for seniors is a highly charged issue. It's not surprising each side makes inflammatory claims. Unfortunately, both sides end up perpetuating the illusion that we can prevent fiscal catastrophe without hard choices or sacrifices.